Daily Yellowstone journal., 1887-01-21
ANTISEPTIC SURGERY.
PROGRESS MADE IN THE ART
WITHIN A FEW YEARS.

improved Metbous OF surgery "hicn
rodu Astounding Notwithstanding
OF Wounds by ''First I~ntention'-Ne-
csssity Of MISUNDERSTANDING.
Fifty years ago, on the minutes Of the
Pennsylvania hospital in this city, especial
mention was made Of the fact that an
amputated finger had healed by first
intention" that is, without the process
OF suppuration and granulation, which Is
the usual mode by which tissues heal.
At the present time il is usual, and not
unusual, to have an amputated leg heal
by the first intention as well as the
wounds made in the performance of
nearly all major and minor operations Of
surgery.
So rapid has been the progress in the
improved methods of what is known as
antiseptic surgery that many medical
men are astoundcd TO hear Of the results
that are being obtained, and the general
public are not ut all aware of the great
advances in the surgical art. Indeed, an
tiScptic surgery has been in its infancy
for less than u dozen years, and has only
received its perfect application within a
few months.
In the human body there exists a repair
alive power by which the separated frag-
ments of a broken bone are united and the
cut surfaces of a wound are united. Tn
simplest mode Of healing an open wound
is by the first intention" or immediate
union" for which surgeons have aimed
for hundreds Of years. They had OBJ
served il in rare instances, and looked
upon it rs u possibility: but, as previously
stated, they seldom succeeded in getting
il. and the instances in which they did
gct il were deserving of special note. IL
union fails by the first intention" in-
ilamrlation superyenes, and healing is ac-
complishcd by "A long and tedious process
Of suppuration and FORMULATION, requiring
several weeks or perhaps months for the
closure of u wound Of any considerable
size. And this is always connected with
a great drain on the vital forces, and dan
ger from blood poisoning.
TIE MoDEIS METHOD
What Is antiseptic surgery. IL con
sists of certain precautions and appli-
ances for the exclusion of the air, and
with the air Of the numerous germs Of
disease and putrefaction which iloat in
il, and the application Of a germicide,
which destroys the vitality Of these germs
during and after operation. The more
perfectly this is done the more likely will
there be procured the primary union, or
union by first intention" Everybody
knows that n cut of a finger, If promptly
tied mp and kept al rest, will heal readily;
but il IL he neglected and allowed To get
particles Of dirt and the germs Of disease
into il there is considerable Inflammation,
the injured member becomes painful and
swollen. discharges matter and is slow to
heal. Autiseptic surgery aims at the sim
plicity of domestic practicable ccurate
coaptation Of the parts, provision being
made for the free discharge Of secretious
from the wound and the seclusion of the
air and germs Of disease. BY the adoption
Of antiSeptic measures the surgeon simply
follows natures Indication. lie puts the
parts in the best possible condition 10 heal
and nature does the healing.
The methods adopted in order 10 secure
this success are simple, and but a little
more expensive, considering the first cost,
but infinitely less costly than the old way
of dressing, when consideration is made
for the time and waste of repeated dress
ings, and the lessened risk OF blood poison
ing and death from exhaustion from pro-
longed suppuration.
CLEANLINESS ESSENTIAL.
The most essential element in antiseptic
surgery is cleanliness. The part 10 be
operated upon, or the point Of injury and
adjacent tissue. is first thoroughly
scrubbed with soap and a fine brush. IL
is then shaved TO remove hair and dead
~cutaneous cells, and afterwards washed
with ether. 10 remove fat and oily matter.
1t is then washed with an %nntiseptic SolII-
tion, and the operation is begun. A small
stream Of the solution is played upon The
parts At short intervals as the operation
progresses. Every opening In the tissues
is washed out with this solution, The rats
are brought together with catsut -rturrs,
which have been rendered %asItir, and
these suturcs are absorbed. consequently,
there is nothing To come away. taigut,
being an animal tissue, is capable al ab-
sorption, AMI is used for l~igaturing vessels,
sewing up the parts. aud for drainage.
For this purpose several strands arv placed
in the deeper part IL . wound aIpl drain
by capillarity. After there ME ne further
sccretions these are absorbed.
After the superficial opening has been
closed and the edges brought ..tO close
opposition, a strip Of protective T. laid
over the line Of suiurcs. Ovcrthi- is spread
n fold of several thiCkncsses of @auac, an
tiscptically prepared, and busted lhickly
on its surface with iUloinrm, over this is
placed cotton, also rendered nutisepiic, aud
the whole dressing is confined In place by
roller handnges. This dressing is put on
wet-all wet, and almost dripping with
the antiseptic solution. The dressing is
not changed, unless there is some sign that
all Is not doing well, until a proper time
has elapsed and il is known that the parts
have healed. Under these methods hos
pitll gnngrcne and crysipelas are very
rarely encountered, and there is so little
discharge of pus that recently IL was i'm
possible to get enough for a sample for
exhibition 10 a class NJ a medical college.
This method, with slight changes in the
detail, is now employed at every good hos
pital In the country and by every surgeon
who is up with the mes.-Philadelphia
North American.
t ~ gs-